Acid Base Balance

Front 1

What is involved in a rapid and complete recovery from acid-case imbalance for a patient?

Back 1

a combination of buffer system activity and the respiratory and renal responses.

Front 2

Serious and prolonged disturbances in acid-base balance can result from any factor that affects any one of which of the principal regulatory mechanisms?

Back 2

Any disorder affecting the circulating buffers, resipratory performances, or renal functions. Cardiovascular conditions, and conditions affecting the CNS

Front 3

When do serious acid-base abnormalities generally show?

Back 3

in an initial acute phase when the pH moves rapidly away from the normal range

Front 4

When does a patient enter the compensated phase and what does that mean?

Back 4

They enter a compensated phase if the initial condition persists and physiological adjustments occur. This means if the underlying problem is not corrected, compensation can not be completed and blood chemistry will remain abnormal.

Front 5

If a patient enters a compensated phase, what happens to pH levels after the compensation occurs?

Back 5

the pH typically remains outside normal limits

Front 6

Resipratory acid-base disorders

Back 6

result from a mismatch beween carbon dioxide generation in peripheral tissues and carbon dioxide excretion at the lungs. The carbon dioxide level of the ECF is abnormal

Front 7

MEtabolic acid-base disorders

Back 7

caused by the generation of organic or fixed acids or by conditions affecting the concentration of acid-base in the ECF

Front 8

What may restore normal acid-base balance in individuals with respiratory acid-base disorders?

Back 8

Resipiratory compensation alone

Front 9

What happens during compensation of metabolic acid-base disorders?

Back 9

compensation mechanisms for metabolic acid-base disorders may be able to stabilize pH, but other aspects of acid-base banace (buffer system function, bicarbonate, and levels) remain abnormal until the underlying metabolic cause is corrected.

Front 10

Interactions between what systems maintain normal acid-base balance?

Back 10

Interactions among buffer systems, respiration, and renal function

Front 11

What happens when buffering mechanisms are severely stressed?

Back 11

the pH wanders outside the normal limits (normal = 7.35 - 7.45) producing symptoms of alkalosis or acidosis

Front 12

What are the four major classes of respiratory and metabolic acid-base disturbance?

Back 12

1. Respiratpry acidosis
2. Respiratory alkalosis
3. Metabloic acidosis
4. Metabolic alkalosis

Front 13

Respiratory acidosis

Back 13

develops when the respiratory system cannot eliminate all the carbon dioxide generated by peripheral tissues.

Front 14

What is the primary symptoms of respiratory acidosis?

Back 14

The primary symptom is low plasma pH due to hypercapnia, an elevated plasma CO2

Front 15

What is usually the cause of respiratory acidosis?

Back 15

Hypoventilation, an abnormally low respiratory rate. When the pCo2 in the ECF rises, and the H+ and HCO3- concentrations also begin rising as H2CO3 forms and dissociates

Front 16

What is the most common challenge to acid-base equilibrium?

Back 16

Respiratory acidosis, because your tissues generate carbon dioxide rapidly

Front 17

Acute respiratory acidosis

Back 17

a life-threatening condition, if chemoreceptors fail to respond by increasing breathing rates, the pH will continue to decline

Front 18

Chronic respiratory acidosis

Back 18

develops when a normal respiratory function has been compromised, but the compensation mechanisms have not failed completely

Front 19

Who is succeptible to chronic respiratory acidosis?

Back 19

People with CNS injuries or those whose respiratory centers have been desensitized by barbiturates or alcohol do not respond to warning signals from the chemoreceptors

Front 20

What are some examples of conditions that foster chronic respiratory acidosis?

Back 20

Emphysems, congestive heart failure, and pneumonia

Front 21

What is the primary problem in respiratory acidosis?

Back 21

that the rate of pulmonary exchange is inadequate to keep the arterial within normal limits

Front 22

What sometimes complicates the treatment of respiratory acidosis?

Back 22

the fact that the treatment causes a complementary metabolic acidosis due to generation of lactic acid in the oxygen-starved tissues

Front 23

Respiratory alkalosis

Back 23

develops when a respiratory acitivty lowers plasma to below normal levels, a condition called hypocapnia

Front 24

What can cause a temporary hypocapnia?

Back 24

Hyperventilation, when increased respiratory activity leads to a reduction in the arterial pCO2

Front 25

What does continued hyperventilation do to pH?

Back 25

Continued hyperventilation can elevate the pH to levels as high as 7.8-8.0

Front 26

What is treatment for respiratory alkolosis?

Back 26

this condition generally corrects itself because the reduction in pH removes the stimulation for the chemoreceptors, so the urge to breath fades until carbon dioxide levels return to normal

Front 27

What are some common causes of hyperventilation?

Back 27

physical stresses such as pain, or psychological stresses such as extreme anxiety

Front 28

What are other causes of respiratory alkalosis?

Back 28

1. individuals adapting to high altitudes
2. patients on mechanical respirators
3. individual w brain stem injuries who are incapable of responding to shifts in plasma concentrations

Front 29

Metabolic Acidosis

Back 29

2nd most common type of acid-base imbalance with three major causes

Front 30

What is the most widespread cause of metabolic acidosis?

Back 30

1. Production of a large # of fixed or organic acids. The hydrogen ions liberated by these acids overload the carbonic acid-bicarbonate buffer system and pH declines

Front 31

What are 2 types of metabolic acidosis?

Back 31

1. Lactic acidosis
2. ketoacidosis

Front 32

Lactic acidosis

Back 32

can develop after strenuous exercise or prolonged tissue hypoxia (oxygen starvation) as active cells rely on anaerobic respiration

Front 33

Ketoacidosis

Back 33

results from the generation of large quantities of ketone bodies during the postabsorptive state of metabolism

Front 34

What two common conditions cause ketoacidosis?

Back 34

Starvation and poorly controlled diabetes mellitus

Front 35

Why do starvation and poorly controlled diabetes cause ketoacidosis?

Back 35

peripheral tissues are unable to obtain adequate glucose from the bloodstream and begin metabolizing lipids and ketone bodies

Front 36

What is a less common cause of metabolic acidosis?

Back 36

an impaired ability to excrete H+ at the kidneys after severe kidney damage

Front 37

The secretion of H+ is directly or indirectly linked to the reabsorption of ____

Back 37

Na+

Front 38

Metabolic acidosis occurs after severe ________ loss

Back 38

bicarbonate

Front 39

What does the carbonic acid-bicarbonate buffer system rely on to balance hydrogen ions?

Back 39

It relies on bicarbonate ions to balance the hydrogen ions that threaten pH balance

Front 40

What reduces the effectiveness of the acid0bicarbonate buffer system?

Back 40

a drop in the HCO3- concentration in the ECF, acidosis soon develops

Front 41

What is the most common cause of HCO3- depletion and why?

Back 41

diarrhea. Under normal conditions, most of the bicarbonate ions secreted into the digestive tract in pancreatic, hepatic, and mucous secretions are reabsorbed before the feces are eliminates. In diarrhea, these bicarbonates are lost and the HCO3- concentration of the ECF drops

Front 42

What is involved in compensation for metabolic acidosis?

Back 42

a combination of respiratory and renal mechanisms. Hydrogen ions interacting with bicarbonate ions form carbon dioxidse molecules that are eliminated at the lungs, whereas the kidneys exrete additional hydrogen ions into the urine and generate bicarbonate ions that are released into the ECF

Front 43

What two acid-base disorders are typically linked?

Back 43

respiratory acidosis and matabolic acidosis are typically linked because osygen-starved tissues generate large quantities of lactic acid and because sustained hypoventilation leads to decreased arterial pO2

Front 44

Metabolic alkalosis

Back 44

occurs when concentrations HCO3- become elevated, bicarbonates then interact with hydrogen ions in solution forming H2CO3

Front 45

Alkaline tide

Back 45

the secretion of hydrochloric acid (HCl) by the gastric mucosa is associated with an influx of large numbers of bicarbonate ions into the ECF